| NPI | 1205216694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: TX U7529) |
| Additional Taxonomies | 208600000X Surgery (Licence: HI 19161) |
| 208600000X Surgery (Licence: TX U7529) | |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2026-08-17 |