| NPI | 1811971062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: CA G79557) |
| Additional Taxonomies | 2086S0127X Surgery Trauma Surgery (Licence: CA G79557) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2007-07-09 |