| NPI | 1104073832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 264148) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301103263) |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2023-02-27 |