| NPI | 1780001099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD475190) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2019033231) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MO 2019033231) | |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2022-02-02 |