| NPI | 1811209950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301096815) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35.138173) |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2020-09-23 |