| NPI | 1871758706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CO DR.0073830) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 103838) |
| 208600000X Surgery (Licence: PA MD480115) | |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2024-10-31 |