| NPI | 1265962401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35.153206) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 271084) |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2025-07-28 |