| NPI | 1760844591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MN 75031) |
| Additional Taxonomies | 208600000X Surgery (Licence: UT 10515015-1205) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2023-09-27 |