| NPI | 1568448207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CT 052254) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 238219-1) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2017-12-07 |