| NPI | 1639552722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CO DR.0069073) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA OT017123) |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2022-07-29 |