| NPI | 1184687337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA G88851) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD00044306) |
| 208600000X Surgery (Licence: MO 2007010595) | |
| 208D00000X General Practice (Licence: CA G88851) | |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2015-07-20 |