| NPI | 1760633218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery Pediatric Surgery (Licence: TX N3982) |
| Additional Taxonomies | 2086S0120X Surgery Pediatric Surgery (Licence: MT 99337) |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2022-04-14 |