| NPI | 1104113802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MO 2024041400) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2024041400) |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2025-01-30 |