| NPI | 1760710743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: GA 080604) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC LL35624) |
| Enumeration Date | 2009-12-02 |
| Last Update Date | 2020-10-26 |