| NPI | 1417215138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35.134343) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP10044576) |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2022-07-21 |