| NPI | 1720345333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101265152) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD461555) |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2023-02-02 |