| NPI | 1629464045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: MO 2023020139) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: NJ 25MA12648700) |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2025-09-18 |