| NPI | 1598113987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 325577) |
| Additional Taxonomies | 208600000X Surgery (Licence: RI LP03701) |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2024-10-04 |