| NPI | 1154574606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: CT 54138) |
| Additional Taxonomies | 208600000X Surgery (Licence: CT 54138) |
| 208600000X Surgery (Licence: FL ME 112785) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL ME112785) | |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2017-05-17 |