| NPI | 1548312374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME159922) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT050189T) |
| 208600000X Surgery (Licence: CA A100428) | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2023-02-15 |