| NPI | 1891317848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OR MD229613) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD.MD.70108125) |
| Enumeration Date | 2020-05-13 |
| Last Update Date | 2026-10-01 |