| NPI | 1730526880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: AZ 56661) |
| Additional Taxonomies | 208600000X Surgery (Licence: RI LP02818) |
| 2086S0129X (Licence: AZ Pending) | |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2020-09-03 |