| NPI | 1851377576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX P1559) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2002-00135) |
| 208600000X Surgery (Licence: NC 0200135) | |
| 208600000X Surgery (Licence: MI 4301096481) | |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2017-02-17 |