| NPI | 1548397375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 78371) |
| Additional Taxonomies | 208600000X Surgery (Licence: NH 12949) |
| 208600000X Surgery (Licence: WI 48610020) | |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2007-07-08 |