| NPI | 1417299868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA11500300) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 298569) |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2025-11-18 |