| NPI | 1316069776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 51735-020) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301078926) |
| 208600000X Surgery (Licence: OH 35 . 089507) | |
| Enumeration Date | 2007-04-05 |
| Last Update Date | 2010-08-17 |