| NPI | 1215969902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: MN 39691) |
| Additional Taxonomies | 208600000X Surgery (Licence: AL 28928) |
| 208600000X Surgery (Licence: WI 37412) | |
| 208600000X Surgery (Licence: TN 46661) | |
| 208600000X Surgery (Licence: VT 0420012124) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2015-11-19 |