| NPI | 1568681286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME81592) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 059742) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2014-10-17 |