| NPI | 1649590209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD446998) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT197583) |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2021-01-02 |