| NPI | 1497802185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: UT 11950226-1205) |
| Additional Taxonomies | 208600000X Surgery (Licence: ME 018869) |
| 2086S0129X (Licence: ME 018869) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2022-02-09 |