| NPI | 1013046994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NM 2004-0707) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101040250) |
| 208600000X Surgery (Licence: NM MD2004-0707) | |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2013-10-11 |