| NPI | 1790047223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: OH 35.142517) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35.142517) |
| 208600000X Surgery (Licence: MA 262254) | |
| 208600000X Surgery (Licence: MA L-252131) | |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2022-12-09 |