| NPI | 1578765475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 278852) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 238345) |
| 207X00000X Orthopaedic Surgery (Licence: IA 39520) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IA 39520) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: KY TP830) | |
| Enumeration Date | 2007-06-03 |
| Last Update Date | 2019-09-03 |