| NPI | 1821339516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MN 72391) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 5101020564) |
| 208600000X Surgery (Licence: FL OS17747) | |
| Enumeration Date | 2013-03-06 |
| Last Update Date | 2023-03-08 |