| NPI | 1467624197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 65212) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 5101017757) |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2025-06-06 |