| NPI | 1790941805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: RI MD17873) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX M9248) |
| 208600000X Surgery (Licence: ME MD18264) | |
| 208600000X Surgery (Licence: MI 4301116561) | |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2023-03-10 |