| NPI | 1407150972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME114421) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036119600) |
| Enumeration Date | 2010-12-27 |
| Last Update Date | 2013-01-07 |