| NPI | 1164782157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MD H91599) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 5101019971) |
| 208600000X Surgery (Licence: NC 2017-00845) | |
| Enumeration Date | 2012-05-23 |
| Last Update Date | 2021-10-20 |