NPI | 1962817890 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: IL 125066226) |
Additional Taxonomies | 208D00000X General Practice (Licence: FL TRN29844) |
Enumeration Date | 2014-06-30 |
Last Update Date | 2021-09-24 |