| NPI | 1255428819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD066480L) |
| Additional Taxonomies | 2086S0120X Surgery Pediatric Surgery (Licence: PA MD066480L) |
| 2086S0120X Surgery Pediatric Surgery (Licence: VA 0101261340) | |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2021-04-15 |