| NPI | 1376074740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A158145) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: CA A158145) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2025-10-21 |