| NPI | 1932408622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301506904) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35-120363) |
| Enumeration Date | 2011-03-21 |
| Last Update Date | 2025-11-04 |