| NPI | 1417489360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: AZ 77169) |
| Additional Taxonomies | 208600000X Surgery (Licence: NM MD2022-0753) |
| 2086S0127X Surgery, Trauma Surgery (Licence: NM MD2022-0753) | |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2025-07-16 |