| NPI | 1720356793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A146283) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2014-01975) |
| 208600000X Surgery (Licence: IL 125057941) | |
| Enumeration Date | 2011-12-06 |
| Last Update Date | 2021-11-29 |