| NPI | 1821291469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME 108486) |
| Additional Taxonomies | 208600000X Surgery (Licence: MS 579-L) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2022-07-18 |