| NPI | 1619388410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME156544) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT206072) |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2022-10-25 |