| NPI | 1831586916 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208600000X Surgery (Licence: NY 312897) | 
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2020022491) | 
| Enumeration Date | 2015-04-16 | 
| Last Update Date | 2025-05-28 |