| NPI | 1801090964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: CT 80892) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 51906) |
| 2086S0129X (Licence: FL ME118845) | |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2025-04-29 |