| NPI | 1114184918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2012-01988) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT190375) |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2014-09-04 |