| NPI | 1740695337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2019-01762) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125064599) |
| 208600000X Surgery (Licence: AZ 61110) | |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2020-06-03 |