| NPI | 1134420839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A116059) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD435265) |
| Enumeration Date | 2010-11-11 |
| Last Update Date | 2012-08-08 |