| NPI | 1114186921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery Pediatric Surgery (Licence: LA MD.207225) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 244454) |
| 2086S0120X Surgery Pediatric Surgery (Licence: PA MD434879) | |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2014-12-17 |