| NPI | 1669867412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MA 287724) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 287724) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2022-08-19 |