| NPI | 1093153728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CO DR.0065562) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY OS018694) |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2022-04-06 |