| NPI | 1821242249 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X (Licence: TX P4256) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 234027) |
| 208600000X Surgery (Licence: TX P4256) | |
| Enumeration Date | 2008-11-12 |
| Last Update Date | 2013-02-05 |