| NPI | 1013902592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: UT 12793568-1205) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 40899) |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2022-11-28 |