| NPI | 1194165662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NM A-2513-21) |
| Additional Taxonomies | 208600000X Surgery (Licence: IA R9727) |
| 208600000X Surgery (Licence: CO 60839) | |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2021-07-12 |