| NPI | 1609018969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: IL 036-143981) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: NC 2016-02388) |
| 208600000X Surgery (Licence: NC 2016-02388) | |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2020-12-07 |