| NPI | 1700907789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: SC 1113) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA OT010330) |
| 208600000X Surgery (Licence: SC 1113) | |
| 2086S0129X (Licence: PA OS013873) | |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2015-11-19 |