| NPI | 1518220474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 84163-20) |
| Additional Taxonomies | 208600000X Surgery (Licence: IA MD44515) |
| Enumeration Date | 2012-06-16 |
| Last Update Date | 2024-09-25 |