| NPI | 1790758837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: TX U4804) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD050420L) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2024-02-16 |