| NPI | 1063827566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101272070) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301106101) |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2021-10-26 |