| NPI | 1619471729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35.153435) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2023-01105) |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2025-08-14 |