| NPI | 1134449382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA C155248) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: PA MT192785) |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2018-06-26 |