| NPI | 1245474287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 281996) |
| Additional Taxonomies | 208600000X Surgery (Licence: CT AS2383278-0729) |
| Enumeration Date | 2009-04-21 |
| Last Update Date | 2017-04-06 |