| NPI | 1164805560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 81536) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA OS020435) |
| 208600000X Surgery (Licence: NV DO2988) | |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2024-09-11 |