| NPI | 1093335176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OR DO224757) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 0000000000) |
| Enumeration Date | 2020-04-20 |
| Last Update Date | 2025-09-04 |