| NPI | 1497952253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: TX Q3408) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25ma08938600) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2025-07-31 |