| NPI | 1407053317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NY 277361) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 57.010858) |
| 208600000X Surgery (Licence: LA 205567) | |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2015-05-21 |