| NPI | 1508802869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD00027022) |
| Additional Taxonomies | 208600000X Surgery (Licence: OR OR14546) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2007-12-07 |