| NPI | 1780034819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CT 085379) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 318167-01) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2026-06-17 |