| NPI | 1619998267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NM A-1818-14) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 4121) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: AZ 4121) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: AZ 4121) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX K1574) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2023-03-10 |