| NPI | 1649262841 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208600000X Surgery (Licence: TX L2623) | 
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: TX L2623) | 
| Enumeration Date | 2005-08-16 | 
| Last Update Date | 2012-02-02 |