| NPI | 1184935421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA 139523) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301097219) |
| 208600000X Surgery (Licence: MA 262418) | |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2021-12-03 |