| NPI | 1831539071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301103795) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 63689) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2019-08-22 |