| NPI | 1740522143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 293870) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 293870-1) |
| Enumeration Date | 2013-03-23 |
| Last Update Date | 2023-01-31 |