| NPI | 1003811985 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: KY 44838) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2002-00267) |
| 2086S0129X (Licence: MA 230012) | |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2022-09-22 |