| NPI | 1912569096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: IA R-13143) |
| Additional Taxonomies | 208600000X Surgery (Licence: ND RL15732) |
| Enumeration Date | 2019-06-28 |
| Last Update Date | 2024-06-13 |