| NPI | 1457761595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 288472) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA10628700) |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2025-08-25 |