| NPI | 1811374341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WV 31046) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT208260) |
| 208600000X Surgery (Licence: VA 0101269570) | |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2022-01-19 |