| NPI | 1477842235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 253322) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NY 253322) |
| Enumeration Date | 2011-04-01 |
| Last Update Date | 2018-09-21 |