| NPI | 1235750779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35.146446) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 57.249351) |
| Enumeration Date | 2020-05-06 |
| Last Update Date | 2025-06-23 |