| NPI | 1154514602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301502392) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD D0066466) |
| Enumeration Date | 2007-08-18 |
| Last Update Date | 2021-03-08 |