| NPI | 1902165277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 288872) |
| Additional Taxonomies | 208600000X Surgery (Licence: CT 70014) |
| 208600000X Surgery (Licence: PA 464434) | |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2022-01-24 |