| NPI | 1780848051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MB09671100) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2008-00441) |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2022-11-01 |