| NPI | 1497011316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A128754) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD61157645) |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2025-09-25 |