| NPI | 1982997011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery Pediatric Surgery (Licence: TX Q1339) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX 558801) |
| Enumeration Date | 2011-05-23 |
| Last Update Date | 2020-09-29 |