| NPI | 1255674792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CT 75623) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101271677) |
| 208600000X Surgery (Licence: GA 91634) | |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2023-08-01 |