| NPI | 1679094486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 77522-21) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125.070501) |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2024-01-18 |