| NPI | 1306068788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: NJ 25MA10231000) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA10231000) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2018-05-02 |