| NPI | 1982835286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA OS015659) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA OT012912) |
| 208600000X Surgery (Licence: TX P9642) | |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2017-01-23 |