| NPI | 1376903708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MN 78919) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 81775) |
| 208C00000X Colon & Rectal Surgery (Licence: MI 5101022337) | |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2025-06-24 |