| NPI | 1659515211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: UT 7771498-1205) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD60449457) |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2024-08-29 |