| NPI | 1881954782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 9701116) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 9701116) |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2017-03-28 |