| NPI | 1851773543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD61198114) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125067690) |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2022-07-29 |