| NPI | 1932183803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD60385717) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX M6034) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2021-05-18 |