| NPI | 1164886826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD481611) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 27520) |
| 208600000X Surgery (Licence: MN 64177) | |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2023-09-15 |