| NPI | 1255358115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35-089052) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 051958) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2021-01-12 |