| NPI | 1346663531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA10640600) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT204025) |
| Enumeration Date | 2014-01-24 |
| Last Update Date | 2019-11-05 |