| NPI | 1912188236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X (Licence: CA C150896) |
| Additional Taxonomies | 208600000X Surgery (Licence: TN 62333) |
| 2086S0129X (Licence: TN 62333) | |
| 208600000X Surgery (Licence: CA C150896) | |
| 2086S0129X (Licence: IA 41064) | |
| 208600000X Surgery (Licence: IA 41064) | |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2026-05-14 |