| NPI | 1083271464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4351046586) |
| Additional Taxonomies | 208600000X Surgery (Licence: RI LP04536) |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2020-06-16 |