| NPI | 1700958253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MA 286101) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35128160) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2025-09-16 |