| NPI | 1023476579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A196510) |
| Additional Taxonomies | 208600000X Surgery (Licence: KS 04-50783) |
| 208600000X Surgery (Licence: KY 55525) | |
| 208600000X Surgery (Licence: SD 17402) | |
| 282N00000X General Acute Care Hospital | |
| Enumeration Date | 2016-01-28 |
| Last Update Date | 2025-08-05 |