| NPI | 1215037981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X (Licence: NJ 25MA06748600) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA06748600) |
| Enumeration Date | 2006-09-23 |
| Last Update Date | 2010-03-07 |