NPI | 1457733784 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: WA OP61153581) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101021906) |
207X00000X Orthopaedic Surgery (Licence: CA 20A18213) | |
Enumeration Date | 2015-06-23 |
Last Update Date | 2021-11-02 |