| NPI | 1487044517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MA 285521) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35.134478) |
| Enumeration Date | 2015-01-27 |
| Last Update Date | 2020-10-26 |