| NPI | 1962812891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OR MD192487) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT205850) |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2021-12-21 |