| NPI | 1063300911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IA R-13991) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2025025412) |
| Enumeration Date | 2025-06-26 |
| Last Update Date | 2026-07-07 |