| NPI | 1205271210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MO 2023033932) |
| Additional Taxonomies | 207QA0401X Family Medicine Addiction Medicine (Licence: VA 0101271396) |
| Enumeration Date | 2013-05-03 |
| Last Update Date | 2023-12-12 |