| NPI | 1144495003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0120X Surgery Pediatric Surgery (Licence: DE C10010496) |
| Additional Taxonomies | 2086S0120X Surgery Pediatric Surgery (Licence: NJ 25MA09439600) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2024-11-12 |