| NPI | 1336353705 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208600000X Surgery (Licence: IA MD41945) | 
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT188335) | 
| 208600000X Surgery (Licence: MN 106875) | |
| 208600000X Surgery (Licence: MN 56862) | |
| Enumeration Date | 2007-05-09 | 
| Last Update Date | 2015-01-06 |