| NPI | 1659716983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: FL ME158030) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: AZ 49554) |
| Enumeration Date | 2013-04-30 |
| Last Update Date | 2022-08-18 |