| NPI | 1194715631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 2386251) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD058943L) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2007-07-08 |