| NPI | 1245626589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: FL OS16972) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 5101021513) |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2021-03-25 |