| NPI | 1376961573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 309693) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA11957500) |
| 208600000X Surgery (Licence: CA A138101) | |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2025-05-15 |