| NPI | 1154570851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: FL ME104191) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 70910) |
| 2086S0129X (Licence: GA 70910) | |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2022-08-22 |