| NPI | 1750902706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IA R-13687) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ R78079) |
| Enumeration Date | 2020-04-30 |
| Last Update Date | 2025-07-15 |