| NPI | 1356637110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME140373) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT200122) |
| 2086S0129X Surgery, Vascular Surgery (Licence: FL ME140373) | |
| 208C00000X Colon & Rectal Surgery (Licence: FL ME140373) | |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2020-11-02 |