| NPI | 1215388251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 334681) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD61526818) |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2025-09-29 |