| NPI | 1750510855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NV 16517) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2013-02433) |
| 208600000X Surgery (Licence: PA MT194435) | |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2019-07-16 |