| NPI | 1922310010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: ME MD23890) |
| Additional Taxonomies | 208600000X Surgery (Licence: NM MD2016-0579) |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2020-09-03 |