| NPI | 1598128290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TN 75066) |
| Additional Taxonomies | 208600000X Surgery (Licence: NM MD2024-0735) |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2025-09-23 |