| NPI | 1669735890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: WV 29161) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 69099) |
| 208600000X Surgery (Licence: MI 301100762) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: WV 29161) | |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2021-11-19 |