| NPI | 1497984033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NE 28503) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2014015778) |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2016-02-16 |