| NPI | 1326574005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD61254404) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A175998) |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2026-04-21 |