| NPI | 1265697247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: FL ME137654) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 52985) |
| 2086S0129X (Licence: MN 52985) | |
| Enumeration Date | 2008-07-19 |
| Last Update Date | 2020-08-31 |