| NPI | 1700307022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MN 528657) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: OH 57.029154) |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2023-11-06 |