| NPI | 1215993795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: KY 31901) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35069721M) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2018-08-31 |