| NPI | 1992119887 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: PA md486613) |
| Additional Taxonomies | 208600000X Surgery (Licence: RI LP03251) |
| 2086S0129X (Licence: FL ME141172) | |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2024-11-15 |