| NPI | 1891363412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OR DO228986) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 5151015306) |
| Enumeration Date | 2021-06-11 |
| Last Update Date | 2026-04-10 |