| NPI | 1760837330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME148906) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2023-00077) |
| Enumeration Date | 2016-05-02 |
| Last Update Date | 2025-08-27 |