| NPI | 1104809326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: TX U0919) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: CT 039775) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2023-01-04 |