| NPI | 1881853307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: WI 73795) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35.096139) |
| 2086S0129X (Licence: OH 35-096139) | |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2021-09-09 |