| NPI | 1487863171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 5101016652) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 34012059) |
| 208600000X Surgery (Licence: IN 02005629A) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2019-03-07 |