| NPI | 1396732079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301073775) |
| Additional Taxonomies | 208600000X Surgery (Licence: CO 49355) |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2016-10-17 |