| NPI | 1790805307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: CO DR0055172) |
| Additional Taxonomies | 208600000X Surgery (Licence: KS 94-06425) |
| 2086S0129X Surgery Vascular Surgery (Licence: MO 2010018543) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2022-07-18 |