| NPI | 1306836127 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA07906800) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA07906) |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2016-02-12 |