| NPI | 1831509595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: GA 88221) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 73067-20) |
| 208600000X Surgery (Licence: AZ 51148) | |
| Enumeration Date | 2014-05-04 |
| Last Update Date | 2021-09-16 |