| NPI | 1073536322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NM MD2006-0821) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ 28204) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2014-01-24 |