| NPI | 1528565736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2023-01706) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 317072) |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2023-11-14 |