| NPI | 1942941315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA 22901) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP10078492) |
| Enumeration Date | 2022-04-07 |
| Last Update Date | 2024-07-29 |