| NPI | 1386728046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: WA MD00044695) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD00044695) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2013-06-17 |