| NPI | 1588076558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MA ETL6070) |
| Additional Taxonomies | 208600000X Surgery (Licence: RI MD16640) |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2024-01-10 |