| NPI | 1710628607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 1710628607) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD 6593) |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2024-06-13 |