| NPI | 1669734497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: AZ 63979) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35.148310) |
| 208600000X Surgery (Licence: IL 125060960) | |
| 208600000X Surgery (Licence: AZ 63979) | |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2023-08-01 |