| NPI | 1629389614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: OH 35125904) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: DC MD210011589) |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2026-01-14 |