| NPI | 1104020940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 350887788) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301108892) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2023-11-03 |