| NPI | 1154682169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: GA 92536) |
| Additional Taxonomies | 208600000X Surgery (Licence: WV 30616) |
| 208600000X Surgery (Licence: TX BP10043382) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: WV 30616) | |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2022-07-11 |