| NPI | 1154760742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD469006) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA L-255573) |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2020-09-23 |