| NPI | 1235139510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 41999 020) |
| Additional Taxonomies | 208600000X Surgery (Licence: LA 14966R) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2012-01-12 |