| NPI | 1710146618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: TX R4869) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 56625) |
| 208600000X Surgery (Licence: TX R4869) | |
| 2086S0102X Surgery Surgical Critical Care (Licence: MN 56625) | |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2021-08-27 |