| NPI | 1558337345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X (Licence: GA 75269) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 166700) |
| 2086S0129X (Licence: NY 166700) | |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2024-08-20 |