| NPI | 1649404138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35.098458) |
| Additional Taxonomies | 208600000X Surgery (Licence: DC 169121) |
| 208600000X Surgery (Licence: VA 0116021552) | |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2016-10-12 |