| NPI | 1194930404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD61504724) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2012-00027) |
| 208600000X Surgery (Licence: OR MD168549) | |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2025-02-25 |