| NPI | 1366070591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD489120) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ P21-01206) |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2025-08-19 |