| NPI | 1083842710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: UT 12139798-1205) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA a119596) |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2026-04-02 |