| NPI | 1215291711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MN 73726) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301100739) |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2023-10-26 |