| NPI | 1316628423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MT235026) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC LL92785) |
| Enumeration Date | 2023-07-31 |
| Last Update Date | 2025-06-25 |