| NPI | 1992774525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD61154801) |
| Additional Taxonomies | 208600000X Surgery (Licence: NE 29835) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2021-08-10 |