| NPI | 1366707739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: MI 5101024392) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ NONE) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2021-02-26 |