| NPI | 1275115909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4351047579) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101289181) |
| Enumeration Date | 2021-04-22 |
| Last Update Date | 2026-04-19 |