| NPI | 1679656607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: VA 0101240686) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 048518) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2013-09-16 |