| NPI | 1235586538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: CA A202931) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A202931) |
| 2086S0129X (Licence: AL MD4611) | |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2025-08-11 |