| NPI | 1669663571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 2012037224) |
| Additional Taxonomies | 208600000X Surgery (Licence: KS 04-35608) |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2019-07-23 |