| NPI | 1649659335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: SC 37645) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC LL37645) |
| Enumeration Date | 2015-05-27 |
| Last Update Date | 2021-08-20 |