| NPI | 1255640124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AZ 62333) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME119641) |
| Enumeration Date | 2010-09-27 |
| Last Update Date | 2021-10-29 |