| NPI | 1083022958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NM MD2019-0150) |
| Additional Taxonomies | 208600000X Surgery (Licence: NM RS2014-0281) |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2024-09-13 |