| NPI | 1770652232 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: UT 8754863-1205) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD60895607) |
| 208600000X Surgery (Licence: CA A117176) | |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2019-11-19 |