| NPI | 1316574965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MB12749500) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 337498-01) |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2025-09-05 |