| NPI | 1184937831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD60779886) |
| Additional Taxonomies | 208600000X Surgery (Licence: OK 29156) |
| Enumeration Date | 2010-07-23 |
| Last Update Date | 2018-07-31 |