| NPI | 1972066702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MB12855600) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 34017032) |
| 2086X0206X Surgery, Surgical Oncology (Licence: OH 34017032) | |
| 208600000X Surgery (Licence: MA 279283) | |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2026-01-26 |