| NPI | 1871501353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 164393-1) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WV RP0003513) |
| 208600000X Surgery (Licence: WV 21979) | |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2007-10-10 |