| NPI | 1831345081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: TX Q4660) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2013-00094) |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2022-06-03 |