| NPI | 1174946073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 170292) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: NY 170292) |
| Enumeration Date | 2014-01-28 |
| Last Update Date | 2017-03-31 |