| NPI | 1225442171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: SD 11588) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC LL37223) |
| 2086S0129X (Licence: VA 0116033191) | |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2022-10-26 |