| NPI | 1861951717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 332390) |
| Additional Taxonomies | 208600000X Surgery (Licence: CO DR.0064961) |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2025-08-15 |