| NPI | 1700348620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA12771200) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 328069-01) |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2025-09-16 |