NPI | 1104317999 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: SC 92979) |
Additional Taxonomies | 208600000X Surgery (Licence: UT 13271767-1205) |
208600000X Surgery (Licence: SC LL52459) | |
208C00000X Colon & Rectal Surgery (Licence: UT 13271767-1205) | |
Enumeration Date | 2018-05-29 |
Last Update Date | 2024-10-01 |