| NPI | 1619355815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: TN 65659) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT208062) |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2022-11-09 |