| NPI | 1700104015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: OK 7204) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 5101018187) |
| 208600000X Surgery (Licence: KY TP417) | |
| 208600000X Surgery (Licence: OK 7204) | |
| 2086S0129X (Licence: KY TP417) | |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2021-05-17 |