| NPI | 1891229837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: UT 10959474-1205) |
| Additional Taxonomies | 208D00000X General Practice (Licence: UT 10959474-1205) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2023-08-30 |