| NPI | 1790045417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036151663) |
| Additional Taxonomies | 208600000X Surgery (Licence: IA MD-45762) |
| Enumeration Date | 2012-05-29 |
| Last Update Date | 2020-10-21 |