| NPI | 1659497709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: OR MD167988) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: NY 269383) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2015-05-14 |