| NPI | 1609049709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2014-02180) |
| Additional Taxonomies | 208600000X Surgery (Licence: ME 018289) |
| 208600000X Surgery (Licence: PA MT183486) | |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2020-12-29 |