| NPI | 1912401308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: IL 036.165209) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036.165209) |
| 2086S0129X (Licence: IN 01096656A) | |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2025-08-13 |