| NPI | 1912187097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: WV 26075) |
| Additional Taxonomies | 208600000X Surgery (Licence: LA PGY.1.TUL-SURG) |
| Enumeration Date | 2007-11-06 |
| Last Update Date | 2014-09-26 |