| NPI | 1386932192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: SC 92925) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ R72675) |
| 208600000X Surgery (Licence: IA R9668) | |
| Enumeration Date | 2011-07-13 |
| Last Update Date | 2025-12-10 |