| NPI | 1881906865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CO DR.0074499) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 274326) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2025-08-14 |