| NPI | 1649466657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101245939) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX S3940) |
| Enumeration Date | 2007-09-24 |
| Last Update Date | 2020-08-12 |