| NPI | 1881937712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: ME MD25775) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 256066) |
| Enumeration Date | 2013-03-28 |
| Last Update Date | 2022-08-26 |