| NPI | 1720097355 |
|---|---|
| Doing Business As | |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 48449) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301078034) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2021-11-22 |