| NPI | 1760467344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA09747000) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 190436) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2022-07-20 |