| NPI | 1467617423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: KY 47398) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2013015509) |
| 208600000X Surgery (Licence: IL 125055417) | |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2020-12-08 |