| NPI | 1679540074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AZ 41195) |
| Additional Taxonomies | 208600000X Surgery (Licence: NJ MA46724) |
| 208600000X Surgery (Licence: NY 1898651) | |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2014-03-28 |