| NPI | 1760584288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD00045206) |
| Additional Taxonomies | 208600000X Surgery (Licence: OR MD24641) |
| Enumeration Date | 2006-09-04 |
| Last Update Date | 2022-02-15 |