| NPI | 1891107876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301117094) |
| Additional Taxonomies | 208600000X Surgery (Licence: RI MD18830) |
| 208600000X Surgery (Licence: MA 290942) | |
| 208600000X Surgery (Licence: PA MT207155) | |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2022-10-31 |