| NPI | 1215189535 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: WA MD60577176) | 
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD60577176) | 
| 208C00000X Colon & Rectal Surgery (Licence: DC MD038383) | |
| Enumeration Date | 2008-10-17 | 
| Last Update Date | 2022-12-06 |