| NPI | 1356655054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 2019010685) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101254829) |
| Enumeration Date | 2010-08-05 |
| Last Update Date | 2019-06-04 |