| NPI | 1821300963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2021-02870) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301096880) |
| 208600000X Surgery (Licence: MN 62347) | |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2021-10-26 |