| NPI | 1588821425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA10074900) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A119395) |
| 208600000X Surgery (Licence: NY 237291) | |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2021-06-15 |