| NPI | 1679868913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: MO 2018016917) |
| Additional Taxonomies | 208600000X Surgery (Licence: KS 94-07720) |
| 2086S0129X Surgery, Vascular Surgery (Licence: TN 59229) | |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2023-01-13 |