| NPI | 1508026444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: SC 35895) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 35895) |
| 208600000X Surgery (Licence: NC 2016-00161) | |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2024-08-29 |