NPI | 1649619990 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: OH 35.134132) |
Additional Taxonomies | 208600000X Surgery (Licence: PA MT203559) |
Enumeration Date | 2013-06-20 |
Last Update Date | 2018-07-24 |