| NPI | 1780760355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OR MD 24580) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD00042573) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2022-02-04 |