| NPI | 1750410262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: CA A79317) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A79317) |
| 2086S0129X (Licence: FL ME107331) | |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2021-12-02 |