| NPI | 1386878494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301109239) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 243429) |
| Enumeration Date | 2009-05-05 |
| Last Update Date | 2016-07-06 |