| NPI | 1578850764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX Q1608) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX 10039788) |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2021-12-03 |