| NPI | 1225250210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: MD D79891) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 225601) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: PA MD445781) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2015-06-15 |