| NPI | 1114454519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A174110) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35144302) |
| Enumeration Date | 2017-05-16 |
| Last Update Date | 2023-09-21 |