| NPI | 1184608788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: GA 104960) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 262780) |
| 208600000X Surgery (Licence: NY 220601) | |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2026-04-22 |