| NPI | 1891717112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: MT 80833) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL OS8205) |
| 208600000X Surgery (Licence: OH 34007687) | |
| 208600000X Surgery (Licence: AK 6547) | |
| 208600000X Surgery (Licence: WV 2389) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2020-04-15 |