| NPI | 1689804759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101278072) |
| Additional Taxonomies | 208600000X Surgery (Licence: AL MD.32264) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MO 2015020981) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: MT MED-PHYS-LIC-123987) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: AL MD.32264) | |
| Enumeration Date | 2009-07-22 |
| Last Update Date | 2024-02-19 |