| NPI | 1336351329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AZ 58365) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL 121213) |
| 208600000X Surgery (Licence: OH 096670) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2019-05-16 |