| NPI | 1750510855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME169228) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT194435) |
| 208600000X Surgery (Licence: NC 2013-02433) | |
| 208600000X Surgery (Licence: NV 16517) | |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2024-09-08 |