NPI | 1154703130 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: CA 187616) |
Additional Taxonomies | 208600000X Surgery (Licence: MI 4301108341) |
208600000X Surgery (Licence: WV 30827) | |
Enumeration Date | 2015-06-25 |
Last Update Date | 2025-01-21 |