| NPI | 1629229026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: PA OS004770L) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA 20A6206) |
| 208D00000X General Practice (Licence: PA KO000087L) | |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2008-10-02 |