| NPI | 1063755395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA12445700) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD467608) |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2024-11-18 |