| NPI | 1699194456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA 138376) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH UUD191618) |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2021-11-29 |