| NPI | 1659392447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NM MD2006-0100) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 812005) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2008-12-10 |