| NPI | 1891226726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 336763) |
| Additional Taxonomies | 208600000X Surgery (Licence: MT MED-PHYS-LIC-113365) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2025-08-14 |