| NPI | 1457475451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WY 8475A) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301086409) |
| 208600000X Surgery (Licence: UT 6989425-1205) | |
| Enumeration Date | 2007-03-17 |
| Last Update Date | 2020-01-21 |