| NPI | 1649590654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX Q4275) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301096159) |
| Enumeration Date | 2010-06-02 |
| Last Update Date | 2021-08-19 |