| NPI | 1164403887 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2012-02224) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 076273) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2021-12-01 |