| NPI | 1407209349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA10346400) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2017-00820) |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2021-07-23 |