| NPI | 1144604976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0120X Surgery Pediatric Surgery (Licence: AL L.4314R) |
| Additional Taxonomies | 208600000X Surgery (Licence: AL L.4314R) |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2019-03-11 |