| NPI | 1972883056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 277438) |
| Additional Taxonomies | 2086S0127X Surgery Trauma Surgery (Licence: NY 277438) |
| 2086S0102X Surgery Surgical Critical Care (Licence: NY 277438) | |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2015-10-27 |