| NPI | 1477971117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OR MD197571) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35.136028) |
| 208600000X Surgery (Licence: WA MD61243605) | |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2022-06-23 |