| NPI | 1740535293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: LA 307100) |
| Additional Taxonomies | 208600000X Surgery (Licence: TN MD53839) |
| 208600000X Surgery (Licence: TX p2027) | |
| Enumeration Date | 2012-07-20 |
| Last Update Date | 2017-12-20 |