| NPI | 1487147583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME162534) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD476460) |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2023-06-20 |