| NPI | 1245551290 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208600000X Surgery (Licence: OR MD157292) | 
| Additional Taxonomies | 208600000X Surgery (Licence: CA A107045) | 
| Enumeration Date | 2010-06-14 | 
| Last Update Date | 2020-10-14 |