NPI | 1124073705 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: MI 4301060606) |
Additional Taxonomies | 208600000X Surgery (Licence: KS 04-28978) |
208600000X Surgery (Licence: CO 50657) | |
208600000X Surgery (Licence: TX k4149) | |
Enumeration Date | 2006-05-23 |
Last Update Date | 2021-03-29 |