| NPI | 1073777140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NM MD2016-0573) |
| Additional Taxonomies | 208600000X Surgery (Licence: CT 050450) |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2016-10-19 |