| NPI | 1376806216 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MN 65587) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT201378) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MN 65587) | |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2020-10-28 |