| NPI | 1811215791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: KS 94-07367) |
| Additional Taxonomies | 208600000X Surgery (Licence: CO DR.0057100) |
| Enumeration Date | 2010-05-17 |
| Last Update Date | 2016-06-27 |