| NPI | 1457301905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MN 34598) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 27215) |
| 208600000X Surgery (Licence: IL 03606305) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2011-10-20 |