| NPI | 1295990240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 265988) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD60720061) |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2018-10-28 |