| NPI | 1265728083 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208600000X Surgery (Licence: TX R7598) | 
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125.059462) | 
| Enumeration Date | 2011-06-20 | 
| Last Update Date | 2019-02-27 |