| NPI | 1013300490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA OS019591) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2020017652) |
| Enumeration Date | 2015-03-10 |
| Last Update Date | 2025-08-13 |