| NPI | 1376974196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD C06125) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA056605) |
| Enumeration Date | 2013-12-04 |
| Last Update Date | 2020-08-10 |