NPI | 1174811780 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: WA MD61152046) |
Additional Taxonomies | 208600000X Surgery (Licence: NY 292357) |
Enumeration Date | 2011-07-17 |
Last Update Date | 2022-05-23 |