| NPI | 1750566493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: GA 054343) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 054343) |
| 208600000X Surgery (Licence: MS 21693) | |
| Enumeration Date | 2007-12-31 |
| Last Update Date | 2020-10-15 |