| NPI | 1619295383 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: NE 31484) | 
| Additional Taxonomies | 208600000X Surgery (Licence: FL TRN14707) | 
| Enumeration Date | 2010-05-05 | 
| Last Update Date | 2019-04-02 |