| NPI | 1124581285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101286503) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: VA 0101286503) |
| Enumeration Date | 2019-04-07 |
| Last Update Date | 2025-09-02 |