| NPI | 1760470777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: NV 7183) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: ID M-16047) |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2021-10-22 |