| NPI | 1285862623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME172846) |
| Additional Taxonomies | 208600000X Surgery (Licence: SD 18404) |
| 208600000X Surgery (Licence: WV 24306) | |
| 208600000X Surgery (Licence: MN 82713) | |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2026-07-10 |