| NPI | 1497217806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD479370) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2023050639) |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2025-09-22 |