| NPI | 1629469473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101262158) |
| Additional Taxonomies | 208600000X Surgery (Licence: ID 5771767) |
| Enumeration Date | 2015-02-16 |
| Last Update Date | 2025-08-21 |