| NPI | 1134198005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: OR MD167013) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 204411) |
| 208600000X Surgery (Licence: WI 59966) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2025-01-27 |