| NPI | 1174969323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: FL ME164641) |
| Additional Taxonomies | 208600000X Surgery (Licence: RI ETL02902) |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2024-04-10 |