| NPI | 1962822692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: MS 26737) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 5101020893) |
| Enumeration Date | 2014-04-21 |
| Last Update Date | 2023-11-30 |