| NPI | 1609853951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AZ 44306) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301075656) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2021-01-04 |