| NPI | 1861657223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: OH 35PENDING) |
| Additional Taxonomies | 208600000X Surgery (Licence: KY 44883) |
| Enumeration Date | 2008-07-25 |
| Last Update Date | 2022-05-04 |