| NPI | 1578514519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2015-01166) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 076291) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2019-12-11 |