| NPI | 1083980015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA12441900) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 294821) |
| 208600000X Surgery (Licence: MD D83330) | |
| Enumeration Date | 2012-03-23 |
| Last Update Date | 2025-01-28 |