| NPI | 1376654210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: TX H5475) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 35077) |
| 208600000X Surgery (Licence: ME 017108) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: TX H5475) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: MN 35077) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: ME 017108) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-08 |