| NPI | 1033395728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA09230400) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 254757) |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2014-09-09 |