| NPI | 1770849093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: CA A186396) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: WA MD61176567) |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2023-09-12 |