| NPI | 1174942080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2023-01619) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 007069) |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2024-02-09 |