| NPI | 1831576867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: GA 102158) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 72211) |
| 208600000X Surgery (Licence: NY 324318) | |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2025-04-17 |