| NPI | 1083851737 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery Pediatric Surgery (Licence: NJ 25MA11248400) |
| Additional Taxonomies | 2086S0120X Surgery Pediatric Surgery (Licence: WI 60942) |
| Enumeration Date | 2009-01-17 |
| Last Update Date | 2021-11-03 |