| NPI | 1639128499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: OR MD177023) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: KY 42458) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2021-02-19 |