| NPI | 1366860892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MA 2778844) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 259581) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2020-11-02 |