| NPI | 1780147959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: UT 13873546-1205) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ R77331) |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2024-07-11 |