| NPI | 1841245354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: ID M5006) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD00023384) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2007-09-20 |