| NPI | 1821470998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101272560) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD61432960) |
| 208600000X Surgery (Licence: IA R10395) | |
| 2086S0129X (Licence: WA MD61432960) | |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2023-07-11 |