| NPI | 1649565748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: ID 471741) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA10194200) |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2025-02-10 |