| NPI | 1821401381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY NY300311) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301104857) |
| 208600000X Surgery (Licence: NY P10702) | |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2022-03-08 |