| NPI | 1174720569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD60271597) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 002409) |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2012-04-04 |