| NPI | 1588821524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD60220733) |
| Additional Taxonomies | 208600000X Surgery (Licence: UT 6360310-1205) |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2022-09-12 |