| NPI | 1972793834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35.132033) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 256526) |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2021-02-22 |