| NPI | 1629389614 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: DC MD210011589) | 
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: OH 35 125904) | 
| Enumeration Date | 2010-06-24 | 
| Last Update Date | 2025-09-23 |