| NPI | 1982133963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: AL MD.51868) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA 61558327) |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2025-09-09 |