| NPI | 1760492102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: TX N2045) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2006-00871) |
| 2086S0129X Surgery Vascular Surgery (Licence: NM MD2003-0671) | |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2012-06-15 |