| NPI | 1174942080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: TX T0204) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2023-01619) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: TX T0204) | |
| 208600000X Surgery (Licence: GA 007069) | |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2025-08-13 |