| NPI | 1073721320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301077660) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2009010047) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2012-04-26 |