| NPI | 1568453884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2005-01462) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 0501462) |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2025-04-07 |