| NPI | 1669790564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CO DR.0060659) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX R4910) |
| 208600000X Surgery (Licence: WI 57026-20) | |
| Enumeration Date | 2010-05-17 |
| Last Update Date | 2018-10-09 |