| NPI | 1790046704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME146543) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2018-01597) |
| 208600000X Surgery (Licence: SC LL34658) | |
| 208600000X Surgery (Licence: TN 56289) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME146543) | |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2020-08-10 |