| NPI | 1518129592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX R9044) |
| Additional Taxonomies | 208600000X Surgery (Licence: HI DOS-1291) |
| 208D00000X General Practice (Licence: HI DOS-1291) | |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2024-01-18 |