| NPI | 1104036672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA OS017869) |
| Additional Taxonomies | 208600000X Surgery (Licence: CO DR.0045761) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2023-05-10 |