| NPI | 1760749667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD60759382) |
| Additional Taxonomies | 208600000X Surgery (Licence: RI MD19458) |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2024-08-30 |