| NPI | 1184943169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD467281) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2015-01203) |
| 208600000X Surgery (Licence: VA 0101283968) | |
| Enumeration Date | 2010-05-31 |
| Last Update Date | 2025-03-25 |