| NPI | 1508896358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: ME 018008) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME93215) |
| 208600000X Surgery (Licence: NH 13223) | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2009-01-29 |