| NPI | 1255584090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: NY 223869) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 238238) |
| 208600000X Surgery (Licence: NY 223869) | |
| 2086S0129X (Licence: MA 238238) | |
| Enumeration Date | 2008-10-24 |
| Last Update Date | 2021-10-04 |