| NPI | 1407909252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: DC MD21665) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101054056) |
| 208600000X Surgery (Licence: MD D0050172) | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2011-11-04 |