| NPI | 1306251459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: WV 3316) |
| Additional Taxonomies | 208600000X Surgery (Licence: KS 94-08411) |
| Enumeration Date | 2014-06-27 |
| Last Update Date | 2023-08-14 |