| NPI | 1326063546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: OR MD207927) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD00038458) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: ID M-13664) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2022-03-29 |