| NPI | 1437654019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OR MD217238) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD61461261) |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2025-09-12 |