| NPI | 1538513189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA 20A22375) |
| Additional Taxonomies | 208600000X Surgery (Licence: CO TL.0005907) |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2024-01-22 |