| NPI | 1548580814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X (Licence: NE 31096) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD60839887) |
| 2086S0129X (Licence: VA 0101258372) | |
| 2086S0129X (Licence: WA MD60839887) | |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2022-07-21 |