| NPI | 1578674990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME102104) |
| Additional Taxonomies | 208600000X Surgery (Licence: NE 22789) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2022-02-10 |