| NPI | 1114181930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: PA mt188230) |
| Additional Taxonomies | 208600000X Surgery (Licence: UT 11849356-1205) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2023-06-21 |