| NPI | 1053317313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: MO MD 32678) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MO MD 32678) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2011-10-11 |