| NPI | 1659395820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: MI 089215) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 089215) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MI 089215) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2014-03-19 |