| NPI | 1417375767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX T5114) |
| Additional Taxonomies | 208600000X Surgery (Licence: NM MD2019-0621) |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2022-09-08 |