| NPI | 1700999083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301080825) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 33528) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2010-03-03 |