| NPI | 1366802258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101263525) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101263525) |
| Enumeration Date | 2016-03-04 |
| Last Update Date | 2026-01-13 |