| NPI | 1972711265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2010-00852) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX AB22180771666) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2010-07-14 |