| NPI | 1316149438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME102870) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 255770-1) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2011-07-11 |