| NPI | 1063772283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA10585500) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 290667) |
| Enumeration Date | 2012-05-22 |
| Last Update Date | 2020-06-04 |