| NPI | 1972599850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VT 0420011460) |
| Additional Taxonomies | 208600000X Surgery (Licence: NH 11117) |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2021-03-10 |