| NPI | 1245478569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA RN061046) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: GA RN061046) |
| Enumeration Date | 2009-01-23 |
| Last Update Date | 2009-01-23 |