| NPI | 1205065695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: PA MD452861) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: NJ 25MA09449500) |
| 208600000X Surgery (Licence: PA MT195540) | |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2016-06-27 |