| NPI | 1508897810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: TX m7325) |
| Additional Taxonomies | 208600000X Surgery (Licence: LA MD.15581R) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2024-08-23 |