| NPI | 1023117421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD60266345) |
| Additional Taxonomies | 208600000X Surgery (Licence: HI MD-13266) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2012-07-30 |