| NPI | 1265645253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: TX Q4052) |
| Additional Taxonomies | 208600000X Surgery (Licence: MS 22405) |
| 208600000X Surgery (Licence: LA MD.207196) | |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2020-06-05 |