| NPI | 1255545216 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD452728) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35.089704) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2020-10-05 |