| NPI | 1336223221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: RI MD20067) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NY 262455-1) |
| 208600000X Surgery (Licence: NY 262455-1) | |
| 208600000X Surgery (Licence: NC 96-10203) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2024-06-28 |