| NPI | 1609018969 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME168598) | 
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2016-02388) | 
| 208600000X Surgery (Licence: IL 036143981) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: IL 036143981) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: IL 036-143981) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: IL 036143981) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: NC 2016-02388) | |
| Enumeration Date | 2009-04-01 | 
| Last Update Date | 2024-08-29 |