| NPI | 1992159800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 67763) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA OP61149398) |
| Enumeration Date | 2016-04-17 |
| Last Update Date | 2023-03-09 |