| NPI | 1275893927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2017-01753) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA OT014673) |
| Enumeration Date | 2012-05-29 |
| Last Update Date | 2022-02-07 |