| NPI | 1669623328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA10778000) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 285845) |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2021-07-23 |