| NPI | 1033616024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301508860) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 327854) |
| Enumeration Date | 2018-04-07 |
| Last Update Date | 2024-03-27 |