| NPI | 1578827499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A174945) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ R73227) |
| 282N00000X General Acute Care Hospital (Licence: IA R-9872) | |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2021-10-14 |