| NPI | 1093200834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD482009) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 57246416) |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2023-09-14 |