| NPI | 1134123003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35085381) |
| Additional Taxonomies | 208600000X Surgery (Licence: NM MD2020-0182) |
| 208600000X Surgery (Licence: WI 56138) | |
| 208600000X Surgery (Licence: PA MD057727L) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: OH 35085381) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD057727L) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: OH 85381) | |
| 208C00000X Colon & Rectal Surgery (Licence: OH 85381) | |
| 208C00000X Colon & Rectal Surgery (Licence: PA MD057727L) | |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2023-03-15 |