| NPI | 1407254568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA OP61290036) |
| Additional Taxonomies | 208600000X Surgery (Licence: OR 177284) |
| Enumeration Date | 2014-12-05 |
| Last Update Date | 2023-01-30 |