| NPI | 1568627529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CT 56500) |
| Additional Taxonomies | 208600000X Surgery (Licence: LA MD205564) |
| 208600000X Surgery (Licence: PA MD448861) | |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2020-06-11 |