| NPI | 1740637560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME135583) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL TRN23225) |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2021-11-11 |