| NPI | 1548830359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX W7294) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2021024015) |
| Enumeration Date | 2021-06-25 |
| Last Update Date | 2026-07-17 |