| NPI | 1770825507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 2021023192) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD470077) |
| Enumeration Date | 2013-03-19 |
| Last Update Date | 2021-09-16 |