| NPI | 1467886697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0120X Surgery Pediatric Surgery (Licence: CA A134338) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A134338) |
| Enumeration Date | 2013-08-23 |
| Last Update Date | 2023-12-05 |