| NPI | 1619300571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0116032191) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA os020157) |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2019-07-28 |