| NPI | 1881115905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 331998) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35.150188) |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2025-08-29 |