| NPI | 1962813758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD460578) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT205826) |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2020-06-07 |