| NPI | 1326570755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301510249) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35.140219) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2023-08-14 |