| NPI | 1497275457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 340913) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2017019570) |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2026-07-08 |