| NPI | 1609038702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME131521) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA08657300) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2020-10-08 |