| NPI | 1699755496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD437467) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 2045-320) |
| 208600000X Surgery (Licence: MI 4301504395) | |
| 208600000X Surgery (Licence: PA MD43767) | |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2023-09-29 |