| NPI | 1033777842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD488975) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT218313) |
| 208600000X Surgery (Licence: VA 0101280699) | |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2025-10-13 |