| NPI | 1679700769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2016-01742) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35121133) |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2024-02-21 |