| NPI | 1861012619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A203248) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: CA A203248) |
| 208600000X Surgery (Licence: AZ R77960) | |
| Enumeration Date | 2020-04-22 |
| Last Update Date | 2026-07-20 |