| NPI | 1720270606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: OH 35.097708) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: MA 266153) |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2020-05-06 |