| NPI | 1417004383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: TX N6810) |
| Additional Taxonomies | 208600000X Surgery (Licence: TN 0000037157) |
| 208600000X Surgery (Licence: CA A99985) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2020-11-05 |