| NPI | 1811954894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 38235) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NC 38325) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2010-08-05 |