| NPI | 1457883696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD61399458) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A175742) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2024-02-19 |