| NPI | 1952309288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA 00G566600) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA 00G566600) |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2011-06-14 |