| NPI | 1962780049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: CA A133093) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 430199125) |
| Enumeration Date | 2011-07-24 |
| Last Update Date | 2018-08-02 |