| NPI | 1114375631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 327174) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD465038) |
| 208600000X Surgery (Licence: NJ 25MA12046500) | |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2024-03-29 |