| NPI | 1730347865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery Pediatric Surgery (Licence: FL ME115912) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 122923) |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2013-07-10 |