| NPI | 1689967440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: KY 51578) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2014-02438) |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2020-10-05 |