| NPI | 1740662170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 77437) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2015019342) |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2022-10-03 |