| NPI | 1063581437 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 240046) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NY 240046) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2007-07-08 |