| NPI | 1992047377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME157681) |
| Additional Taxonomies | 208600000X Surgery (Licence: IA MD-45241) |
| 208600000X Surgery (Licence: NY 283899) | |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2023-09-29 |