| NPI | 1255836540 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NJ 25MA12255600)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2018-03-28 | 
| Last Update Date | 2024-06-07 |