| NPI | 1205277225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NE 1905) |
| Additional Taxonomies | 208600000X Surgery (Licence: KS 05-42326) |
| 208600000X Surgery (Licence: NE 7087) | |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2019-10-08 |