| NPI | 1417157009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD438400) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA08664200) |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2015-07-08 |