| NPI | 1225491814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: DC MD600004633) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 73676) |
| 2086S0129X (Licence: MN 73676) | |
| 208600000X Surgery (Licence: VA 0101265061) | |
| 2086S0129X (Licence: VA 0101265061) | |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2025-10-24 |