| NPI | 1356637037 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: KS 05-38968) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 5101019467) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2021-03-18 |