| NPI | 1588781926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: NE 1369) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036-114348) |
| 2086S0129X (Licence: CA 20a10488) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2025-04-21 |