| NPI | 1184627242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD442851) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD D0060169) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2020-08-10 |