| NPI | 1700204559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 2019012299) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 1700204559) |
| Enumeration Date | 2014-03-30 |
| Last Update Date | 2026-02-18 |