| NPI | 1730165879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME114784) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101045510) |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2017-02-06 |