| NPI | 1063597540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 45794) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 45794-020) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2010-11-10 |