| NPI | 1962473132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AZ 66072) |
| Additional Taxonomies | 208600000X Surgery (Licence: CO 49875) |
| 208600000X Surgery (Licence: OR 173564) | |
| 208600000X Surgery (Licence: WA MD00042564) | |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2022-06-14 |