| NPI | 1871905752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0102206106) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2019-00644) |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2021-07-21 |