| NPI | 1912132218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: GA 85000) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME124836) |
| 208600000X Surgery (Licence: IN 01074001A) | |
| Enumeration Date | 2009-05-16 |
| Last Update Date | 2020-07-06 |