| NPI | 1376504159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: MI 4301093975) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: OH 35.097499) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2022-09-06 |