| NPI | 1982866133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: FL ME116752) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME116752) |
| 2086S0129X (Licence: OH 35.126663) | |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2018-08-16 |