| NPI | 1598992687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD60767820) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35.122888) |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2022-07-21 |