| NPI | 1811903255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: OK 29923) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: TX J5604) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: SD 8950) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: IA 41103) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: FL ME89224) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2021-06-30 |