| NPI | 1598147217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2021-02648) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 34.014360) |
| 208600000X Surgery (Licence: PA OT016784) | |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2021-08-17 |