| NPI | 1215342985 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: KY 54465) |
| Additional Taxonomies | 208600000X Surgery (Licence: NE 36858) |
| Enumeration Date | 2014-06-21 |
| Last Update Date | 2025-08-28 |