| NPI | 1992299713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: GA 96227) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA OT018587) |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2023-10-11 |