| NPI | 1104815059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MD H65424) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 34006614) |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2013-12-05 |