| NPI | 1679981104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO CDR.0000681) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: MI L256922) |
| 282N00000X General Acute Care Hospital (Licence: MI L256921) | |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2021-01-12 |