| NPI | 1336590793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A171809) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301110325) |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2022-07-11 |