| NPI | 1962403832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 28491-020) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 28491-020) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2025-09-11 |