| NPI | 1063732634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2015-00330) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC LL32642) |
| 2086S0129X (Licence: NC 2015-00330) | |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2020-10-25 |