| NPI | 1366001851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: SC 82779) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC LL82779) |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2024-08-20 |