| NPI | 1346456118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD446469) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2011-00670) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2019-08-12 |