| NPI | 1437151198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA G061008) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA G61008) |
| 208600000X Surgery (Licence: AK 05790) | |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2014-03-14 |