| NPI | 1528455326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MN 66582) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301503191) |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2022-11-17 |