| NPI | 1073142618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 342759) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2025011254) |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2026-08-04 |