| NPI | 1336378512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: WA MD60472814) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD60472814) |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2017-11-02 |