| NPI | 1477963270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CO DR.0071443) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35.135605) |
| 208600000X Surgery (Licence: AZ 60454) | |
| Enumeration Date | 2014-05-01 |
| Last Update Date | 2023-08-22 |