| NPI | 1104060466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A117875) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA08805700) |
| Enumeration Date | 2009-04-29 |
| Last Update Date | 2022-03-01 |