| NPI | 1801039615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A13771) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2014-00186) |
| Enumeration Date | 2009-04-08 |
| Last Update Date | 2016-06-08 |