| NPI | 1972596070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CO DR.0050346) |
| Additional Taxonomies | 208600000X Surgery (Licence: TN MD25837) |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2017-01-09 |