| NPI | 1467763300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A169254) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: WI 69950) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD456012) | |
| 208600000X Surgery (Licence: NC 2016-01128) | |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2020-09-02 |