| NPI | 1508394636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME154561) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP10061323) |
| Enumeration Date | 2017-06-02 |
| Last Update Date | 2022-09-02 |