| NPI | 1518353358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA11292500) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 303267) |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2022-02-22 |