| NPI | 1356580575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: CT 66762) |
| Additional Taxonomies | 208600000X Surgery (Licence: CT 66762) |
| Enumeration Date | 2009-02-11 |
| Last Update Date | 2020-11-01 |