| NPI | 1669033114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MN 79527) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2020013288) |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2025-08-15 |