| NPI | 1578828455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 2020010320) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: MI 4301101521) |
| Enumeration Date | 2012-07-07 |
| Last Update Date | 2024-04-09 |