| NPI | 1528597002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: SC 91169) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD484296) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD484296) | |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2025-09-02 |