| NPI | 1578753521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: TN MD45382) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0116016609) |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2025-11-06 |