| NPI | 1679952048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: LA 311065) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2020014578) |
| 2086S0129X (Licence: MO 2020014578) | |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2025-03-26 |