| NPI | 1609389287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: KY 60785) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX U3190) |
| Enumeration Date | 2017-11-06 |
| Last Update Date | 2025-06-20 |