| NPI | 1376773317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 2011018904) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA OS014299) |
| 208600000X Surgery (Licence: IN 02003717B) | |
| Enumeration Date | 2009-07-24 |
| Last Update Date | 2012-10-02 |