| NPI | 1700096088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35121983) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2007-00092) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2023-11-03 |