| NPI | 1639430986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME151405) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL 17324) |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2021-08-11 |