| NPI | 1679786693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MN 69838) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ 40610) |
| 208600000X Surgery (Licence: MI 4301102357) | |
| 208600000X Surgery (Licence: CA A136276) | |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2021-09-08 |