| NPI | 1578185898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OR MD202379) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD61065324) |
| Enumeration Date | 2020-05-08 |
| Last Update Date | 2022-01-27 |