| NPI | 1316334436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: WA MD70012124) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: PA MD470128) |
| 208C00000X Colon & Rectal Surgery (Licence: MI 4351047411) | |
| 208C00000X Colon & Rectal Surgery (Licence: IL 036.161211) | |
| Enumeration Date | 2015-04-16 |
| Last Update Date | 2025-07-22 |