| NPI | 1508270224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: DC DO034875) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL UO3530) |
| 208600000X Surgery (Licence: VA 0102206202) | |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2020-10-16 |