| NPI | 1548503386 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301506549) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35.126313) |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2023-02-01 |