| NPI | 1366635880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101263531) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2009-01607) |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2022-08-09 |