| NPI | 1881758951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OR MD187052) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD60846825) |
| 208600000X Surgery (Licence: MT MED-PHYS-LIC-67074) | |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2019-09-27 |