| NPI | 1932451689 |
|---|---|
| Former Name | MICHELLE TOMASA GANYO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101254549) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 94934) |
| 286500000X Military Hospital | |
| Enumeration Date | 2012-10-04 |
| Last Update Date | 2023-05-04 |