| NPI | 1255438370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA G84156) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101052686) |
| 208D00000X General Practice (Licence: CA G84156) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2014-07-09 |