| NPI | 1174512347 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CO DR.0040596) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD00047323) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2021-03-12 |