| NPI | 1134207160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: MN 30027) |
| Additional Taxonomies | 282NC0060X General Acute Care Hospital, Critical Access (Licence: ME MD21011) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2016-12-14 |