| NPI | 1528472800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A166893) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD472470) |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2022-12-07 |