| NPI | 1316563646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 85610-20) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4351046381) |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2025-07-16 |