| NPI | 1649684150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0102209177) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA OT016092) |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2025-08-01 |