| NPI | 1629457593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD60766820) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA 605466065) |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2023-08-02 |