| NPI | 1083688204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2015-01593) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC 83074) |
| 208600000X Surgery (Licence: DE C2-0007019) | |
| 2086S0102X Surgery Surgical Critical Care (Licence: SC 83074) | |
| 208C00000X Colon & Rectal Surgery (Licence: NC 2015-01593) | |
| 208C00000X Colon & Rectal Surgery (Licence: PA OS015240) | |
| 208C00000X Colon & Rectal Surgery (Licence: SC 83074) | |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2021-07-01 |