| NPI | 1801182902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: ID 6371280) |
| Additional Taxonomies | 208600000X Surgery (Licence: NM MD2017-0610) |
| 208600000X Surgery (Licence: SC LL33752) | |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2025-11-17 |