| NPI | 1861653180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: OR MD162813) |
| Additional Taxonomies | 208600000X Surgery (Licence: OR MD162813) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2016-03-01 |