| NPI | 1639325681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X (Licence: IL 036121509) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036121509) |
| 2086S0129X (Licence: CO 0054184) | |
| Enumeration Date | 2008-08-11 |
| Last Update Date | 2018-07-17 |