| NPI | 1629194212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: AR E-5095) |
| Additional Taxonomies | 208600000X Surgery (Licence: MS T-2881) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2014-08-12 |