| NPI | 1902034028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: WA MD61066495) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD61066495) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2021-11-10 |