| NPI | 1114223682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NJ 25MA10405400) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 268220) |
| 208600000X Surgery (Licence: NJ 25MA10405400) | |
| Enumeration Date | 2011-02-01 |
| Last Update Date | 2023-04-14 |