| NPI | 1285995951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2018-02779) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125060904) |
| 208600000X Surgery (Licence: NJ 25MA10176400) | |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2020-01-23 |