| NPI | 1821175274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: KY 57260) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35081608L) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2026-08-25 |