| NPI | 1104129642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: MO 2024007127) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2024007127) |
| Enumeration Date | 2010-12-06 |
| Last Update Date | 2025-04-17 |