| NPI | 1093747479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: MN 37572) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA G78231) |
| 208600000X Surgery (Licence: NY 189116) | |
| 208600000X Surgery (Licence: NM MD2014-0794) | |
| 208600000X Surgery (Licence: KS 04-35291) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2014-10-30 |