| NPI | 1720602378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: MA 1024184) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 5151014585) |
| Enumeration Date | 2020-05-29 |
| Last Update Date | 2025-06-30 |