| NPI | 1497802599 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101226379) | 
| Additional Taxonomies | 208600000X Surgery (Licence: DC MD038970) | 
| 208600000X Surgery (Licence: MD D0071083) | |
| Enumeration Date | 2007-01-04 | 
| Last Update Date | 2011-11-15 |