| NPI | 1154460160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IA 38649) |
| Additional Taxonomies | 208600000X Surgery (Licence: NM 2003-0241) |
| 208600000X Surgery (Licence: CA A104503) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2009-12-30 |