| NPI | 1831401553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA09627200) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 283203) |
| Enumeration Date | 2010-07-10 |
| Last Update Date | 2022-04-07 |