| NPI | 1174750889 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA10686400) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125056615) |
| 208600000X Surgery (Licence: NY 300793-01) | |
| 208600000X Surgery (Licence: OH 35.133945) | |
| 208600000X Surgery (Licence: WI 66644) | |
| Enumeration Date | 2009-06-19 |
| Last Update Date | 2020-09-16 |