| NPI | 1699943720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: TX T7481) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301085460) |
| 208600000X Surgery (Licence: IL 036.133767) | |
| Enumeration Date | 2008-02-12 |
| Last Update Date | 2024-03-07 |