| NPI | 1407016108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME146371) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 246679-1) |
| 208600000X Surgery (Licence: NJ 25MA08805600) | |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2022-04-20 |