| NPI | 1710340617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX T1124) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.137071) |
| 208D00000X General Practice (Licence: VA 0101263217) | |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2025-08-12 |