| NPI | 1114261591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: WI 70750) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MI 4301502411) |
| 2086S0129X Surgery, Vascular Surgery (Licence: MN 61552) | |
| Enumeration Date | 2012-11-25 |
| Last Update Date | 2021-01-04 |