| NPI | 1336582063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: VA 0102206566) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: CA 20A13676) |
| 207X00000X Orthopaedic Surgery (Licence: CA 20A13676) | |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: CA 20A13676) | |
| Enumeration Date | 2013-04-11 |
| Last Update Date | 2023-07-27 |