| NPI | 1205563202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35.143696) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: IL 036176039) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-08-01 |
| Last Update Date | 2025-09-02 |