| NPI | 1336435494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: WI 75466) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301098422) |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2021-08-02 |