| NPI | 1902921067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME1133344) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC LL 29019) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2022-07-21 |