| NPI | 1720004971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: TX 45844) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: PA MD048024L) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: AL 28280) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: NY 226021) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2021-11-22 |