| NPI | 1568559235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: MN 53928) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 45340-020) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2020-08-14 |