| NPI | 1245227792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: UT 276890-1205) |
| Additional Taxonomies | 208600000X Surgery (Licence: ID M-13814) |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2022-01-20 |