| NPI | 1770842429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CO DR.0062790) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101255763) |
| 208D00000X General Practice (Licence: VA 0101255763) | |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2023-05-01 |