| NPI | 1568682490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35.120367) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA a88994) |
| 2086S0129X (Licence: FL me107137) | |
| 2086S0129X (Licence: OH 35.120367) | |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2021-11-04 |