| NPI | 1164423109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: KY 43967KY) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA07458500) |
| 208600000X Surgery (Licence: NY 228588) | |
| 208600000X Surgery (Licence: PA MD430562) | |
| Enumeration Date | 2005-08-01 |
| Last Update Date | 2011-11-18 |