| NPI | 1184687576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD063411L) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 175014) |
| Enumeration Date | 2006-04-08 |
| Last Update Date | 2016-06-20 |