| NPI | 1639178635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 30082) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX L6743) |
| 208600000X Surgery (Licence: ME 012012) | |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2023-04-17 |