| NPI | 1912964107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: TX J7469) |
| Additional Taxonomies | 202K00000X (Licence: TX J7469) |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: TX J7469) | |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2020-07-02 |