| NPI | 1609913979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 302932) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 227578) |
| 208600000X Surgery (Licence: VA 0101250126) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2024-01-31 |