| NPI | 1689996142 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: NJ 25ma09331900) | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 250591) | 
| Enumeration Date | 2010-02-24 | 
| Last Update Date | 2014-01-15 |