| NPI | 1275981144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 85964-20) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101263203) |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2025-07-31 |