| NPI | 1710191978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: NE 27342) |
| Additional Taxonomies | 208600000X Surgery (Licence: NE 5252) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2017-07-18 |