| NPI | 1952835589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MB11979500) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA OT017711) |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2023-09-27 |