| NPI | 1679969323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 67229-20) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 5920) |
| 208600000X Surgery (Licence: FL ME156348) | |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2023-08-15 |