| NPI | 1639389679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: MN 51423) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 51423) |
| 208600000X Surgery (Licence: MN 103986) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: PA MD72226L) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2020-08-19 |