| NPI | 1710305370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 315070) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 315070) |
| 208600000X Surgery (Licence: MA 286389) | |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2023-07-17 |