| NPI | 1215165691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 306601) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX P4700) |
| 208600000X Surgery (Licence: MD P24036) | |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2022-01-04 |