| NPI | 1720286891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NM MD2018-0692) |
| Additional Taxonomies | 208600000X Surgery (Licence: AK 6943) |
| 208600000X Surgery (Licence: CA A119324) | |
| 208600000X Surgery (Licence: AZ 80929) | |
| 2086S0129X (Licence: WA MD60512058) | |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2025-01-27 |