| NPI | 1508386012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2024-01358) |
| Additional Taxonomies | 208600000X Surgery (Licence: IA R-11051) |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2025-03-26 |