| NPI | 1255695409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: PA MD466757) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT202320) |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2019-06-15 |