| NPI | 1811177330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD447082) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A94539) |
| 208600000X Surgery (Licence: FL ME109632) | |
| Enumeration Date | 2007-11-13 |
| Last Update Date | 2017-03-21 |