| NPI | 1326473802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TN DO3454) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 390200000) |
| Enumeration Date | 2013-09-04 |
| Last Update Date | 2020-06-25 |