| NPI | 1154594919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: ND 14813) |
| Additional Taxonomies | 208600000X Surgery (Licence: ND 14813) |
| 208600000X Surgery (Licence: PA MD446591) | |
| 2086S0102X Surgery Surgical Critical Care (Licence: CA C160683) | |
| Enumeration Date | 2008-04-11 |
| Last Update Date | 2020-09-22 |