| NPI | 1104051200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD451073) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT194819) |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2023-05-04 |