| NPI | 1639557820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD471785) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT208066) |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2022-08-08 |