| NPI | 1346408101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: NC 20015-00120) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 148991) |
| 208600000X Surgery (Licence: NC 2015-00120) | |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2015-06-11 |