| NPI | 1851432363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD602082383) |
| Additional Taxonomies | 208600000X Surgery (Licence: ME MD18217) |
| 208600000X Surgery (Licence: PA MD423091) | |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2016-06-16 |