| NPI | 1164672895 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25ma09175800) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 260728) |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2013-01-09 |