| NPI | 1265530992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX M6069) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2005-01748) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2013-07-03 |