| NPI | 1528310992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD457291) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA09043100) |
| 208600000X Surgery (Licence: ME MD20173) | |
| Enumeration Date | 2012-10-10 |
| Last Update Date | 2024-10-31 |