| NPI | 1205396777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: KY 06061) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX U9311) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2026-08-05 |