| NPI | 1003296500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD61320074) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 263480) |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2022-10-06 |