| NPI | 1629338835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: LA 306668) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A162704) |
| Enumeration Date | 2012-05-22 |
| Last Update Date | 2022-07-19 |