| NPI | 1487880852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MD D0073837) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 245550) |
| 208600000X Surgery (Licence: FL ME106363) | |
| Enumeration Date | 2009-05-29 |
| Last Update Date | 2012-06-07 |