| NPI | 1871097865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2025-01527) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 288100) |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2025-12-26 |