| NPI | 1689896201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 2009022743) |
| Additional Taxonomies | 208600000X Surgery (Licence: NE 5514) |
| 208600000X Surgery (Licence: OH 35.126550) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2021-08-18 |