| NPI | 1306414289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA12898600) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT223514) |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2026-06-12 |