| NPI | 1093129173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: UT 11222369-1205) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301105559) |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2025-02-26 |