| NPI | 1083626923 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME99730) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301087400) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2025-08-01 |