| NPI | 1528488392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0120X Surgery Pediatric Surgery (Licence: VA 0101259629) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101259629) |
| Enumeration Date | 2014-04-21 |
| Last Update Date | 2025-09-04 |