| NPI | 1023465838 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: MN 77910) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125.068292) |
| 208600000X Surgery (Licence: MO 2023019403) | |
| Enumeration Date | 2016-05-22 |
| Last Update Date | 2024-10-09 |