| NPI | 1235393737 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101247525) | 
| Additional Taxonomies | 208600000X Surgery (Licence: NY 289972) | 
| 208600000X Surgery (Licence: ME 131090) | |
| Enumeration Date | 2008-07-14 | 
| Last Update Date | 2024-06-20 |