| NPI | 1033557459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X (Licence: GA 86237) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0116025753) |
| 208600000X Surgery (Licence: GA 86237) | |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2022-02-07 |