| NPI | 1962573022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MN 55899) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301098364) |
| Enumeration Date | 2006-11-12 |
| Last Update Date | 2018-05-17 |