| NPI | 1598129835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2022-02447) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD D80542) |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2022-12-28 |