| NPI | 1528358983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301099239) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 201601008) |
| Enumeration Date | 2011-04-19 |
| Last Update Date | 2022-07-29 |