| NPI | 1528371895 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301500635) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME126441) |
| Enumeration Date | 2010-07-15 |
| Last Update Date | 2021-06-28 |