| NPI | 1245684083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: GA 92616) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME133827) |
| Enumeration Date | 2016-04-18 |
| Last Update Date | 2022-11-14 |