| NPI | 1215156476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 2012012186) |
| Additional Taxonomies | 208600000X Surgery (Licence: ND 12301) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2022-07-21 |