| NPI | 1629125380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME107640) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT179830) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2011-01-10 |