| NPI | 1285096818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101279086) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 316429-01) |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2023-10-10 |