NPI | 1811307879 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: WA MD60657714) |
Additional Taxonomies | 208600000X Surgery (Licence: WI 72449) |
Enumeration Date | 2014-04-30 |
Last Update Date | 2021-10-05 |