| NPI | 1700112240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD60668463) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: WA MD60668463) |
| 2086S0127X Surgery Trauma Surgery (Licence: WA MD60668463) | |
| Enumeration Date | 2009-10-18 |
| Last Update Date | 2025-05-02 |