| NPI | 1558643437 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: MA 283841) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP10039777) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2020-08-01 |