| NPI | 1083625164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35.078556) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101240342) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2016-10-05 |