| NPI | 1366935694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35.156174) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036156864) |
| 208600000X Surgery (Licence: IL 125.071744) | |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2026-07-09 |