| NPI | 1457746190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 313740-01) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA12324500) |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2025-03-12 |