| NPI | 1770567398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AZ 25967) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 200100547) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2020-09-03 |