| NPI | 1851684666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: VA 0102205217) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0102205217) |
| 2086S0129X (Licence: WA op61344996) | |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2023-02-28 |