| NPI | 1801899943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35-05-5279) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35055279b) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2012-02-09 |