| NPI | 1568887495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 5151010296) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 5101021015) |
| 208600000X Surgery (Licence: VA 0102205602) | |
| Enumeration Date | 2014-03-01 |
| Last Update Date | 2025-03-25 |