| NPI | 1760450613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: OH 35-067186) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH State License) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2018-03-09 |