| NPI | 1861756397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301509969) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 1861756397) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2023-08-23 |