| NPI | 1174801328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD607602) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: LA 303044) |
| 208600000X Surgery (Licence: ND RL 12000) | |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2022-11-29 |