| NPI | 1689665275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2017-01535) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 200486) |
| 208600000X Surgery (Licence: LA MD200486) | |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2022-08-30 |