| NPI | 1780661413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA C166294) |
| Additional Taxonomies | 208D00000X General Practice (Licence: HI MD-13623) |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2022-09-22 |