| NPI | 1003920596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A116674) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA ML20008204) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2012-02-16 |