| NPI | 1629456504 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208VP0000X  (Licence: OK 31512)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 31512)  | 
| 208VP0000X  (Licence: MN 60860)  | |
| 207L00000X Anesthesiology (Licence: MN 60860)  | |
| Enumeration Date | 2015-05-12 | 
| Last Update Date | 2025-10-03 |