| NPI | 1598151474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: MN 67267) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MN 67267) |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2022-07-08 |