| NPI | 1588826705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: WI 62567) |
| Additional Taxonomies | 208600000X Surgery (Licence: IA R-8454) |
| 208600000X Surgery (Licence: WI 62567) | |
| Enumeration Date | 2008-06-29 |
| Last Update Date | 2020-01-22 |