| NPI | 1225262033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 66041-20) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX Q4456) |
| 208600000X Surgery (Licence: KY R2050) | |
| Enumeration Date | 2009-05-07 |
| Last Update Date | 2021-01-25 |