| NPI | 1316471014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: SC 94150) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT213272) |
| 2086S0129X (Licence: NC 315570) | |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2025-07-15 |