| NPI | 1487031753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA OP61222129) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ 008634) |
| Enumeration Date | 2015-05-06 |
| Last Update Date | 2022-02-17 |