| NPI | 1619173838 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101270338) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX S2120) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2020-08-20 |