| NPI | 1063466712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: DE C1-0024031) |
| Additional Taxonomies | 174400000X Specialist (Licence: MA 222993) |
| 208600000X Surgery (Licence: MA 222993) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2021-01-07 |