| NPI | 1205135530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: WA MD60956773) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A123935) |
| Enumeration Date | 2011-03-25 |
| Last Update Date | 2020-07-23 |