| NPI | 1841279866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AR E-13904) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 46992) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: WA MD60466675) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: TX P0598) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: MT 86126) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: VA 0101269229) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: OK 36197) | |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2021-05-21 |