| NPI | 1477903979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD478754) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD61185317) |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2023-06-19 |