| NPI | 1942387840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: TX 7550) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: MI 4301070501) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: OH 35-08-0120-C) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-07-08 |