| NPI | 1972866770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD454785) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT201110) |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2020-06-10 |